‘A vicious cycle’: Low Covid-19 vaccination rates lead to fewer doses at pediatric offices. Now, some parents can’t find it

By Amanda Musa, CNN

(CNN) — Last year, days after the Moderna and Pfizer/BioNTech Covid-19 vaccines were authorized for emergency use in children as young as 6 months, Laura Labarre’s children’s pediatrician’s office held a large drive-through vaccine event at a local amusement park.

“It was beautifully organized, and we just drove right up. The kids never even got out of their car seats,” said Labarre, a mom of two in Portland, Oregon.

This fall, wanting to get her kids the updated Covid-19 vaccine that was released in mid-September, she called the same pediatrician’s office, thinking it would be a piece of cake.

But a recorded message informed her: “If you are calling about pediatric Covid-19 vaccines, we will not be offering this service.”

“I had had a pretty easy time up to that point finding vaccines for my kids,” Labarre said. “With the government rollout, their pediatrician had them almost instantly.”

During the Covid-19 public health emergency, coronavirus vaccines were purchased by the federal government and distributed to doctor’s offices. The only thing doctors had to worry about was how to store the vaccines, which require ultra-cold storage or refrigeration for up to a month.

Now, doctors must pay for the shots up-front, and low uptake of the updated vaccine has led some pediatricians to skip ordering it, sometimes making shots difficult for parents to find.

As of November 25, less than 3% of children 6 months to 4 years and 10% of children 12 to 17 have received the new shot, according to the US Centers for Disease Control and Prevention. And a weekly survey of parents by the agency finds that 44% say they definitely or probably will not get the shot for their children.

Dr. Jesse Hackell, who chairs the American Academy of Pediatrics’ Committee on Practice and Ambulatory Medicine, says that when the latest vaccine was released in September, “the people who really wanted it came in early, and they got it.”

But that trend has since petered out, leaving doctors who ordered several doses of the vaccine with no one to administer them to.

According to Hackell, 10 doses of the updated shot can cost doctors up to $1,300. He says many pediatricians are reluctant to buy doses and potentially be at a loss.

“If we give one dose and have to return nine, we’ll get credit for those, but you can only return it after they expire, which is like five months or a year down the line,” he says. “Pediatricians work on very small margins. That kind of time, that kind of money, is not something that we can do easily.”

If pediatricians don’t have the vaccine on hand when a parent asks for it, Dr. Katherine Matthias, a pediatrician in South Carolina, worries that they might think pediatricians don’t really find them all that important.

“It’s almost a vicious cycle where some pediatricians feel like they don’t really want to keep it in stock because the uptake is so low,” Matthias said. “But part of the reason that uptake is so low is because it’s so hard to find.”

Parents have run into other problems too, such as delayed dose delivery to pediatricians.

Elizabeth Lanphier of Cincinnati, Ohio, says she called her pediatrician’s office repeatedly this fall to get her 14-month-old vaccinated and was told shots weren’t available.

“I kept calling back and was told that they didn’t yet have it and that they were waiting on orders from the state,” Lanphier said. “There were all of these logistical hurdles that they were encountering on their end, as far as I know.”

She was finally able to secure a Covid-19 vaccine appointment for her youngest child for next week – nearly three months after the vaccine was released.

“I’ll say that it’s really frustrating to keep hearing the public health messaging which is, ‘make a plan to get your family vaccinated; make a plan to protect yourself against Covid,’ and to be continually trying to make a plan and to be completely unable to do so.”

Further complicating matters, children’s access to the updated shot at pharmacies has changed. Before the Covid-19 public health emergency ended, pharmacists nationwide had permission from the federal government to immunize children as young as 3. Now, each state has a minimum age for administration.

Labarre, who then had a 2-year-old and a 4-year-old, struggled to find somewhere that would vaccinate both of her children at the same time.

“I started widening my search,” she said, booking appointments at pharmacies that were two hours from home. “I made four appointments at pharmacies that got canceled over the course of almost two months.”

Labarre’s luck changed recently when her youngest turned 3 and she found a Costco store 30 minutes from her home that had vaccine appointments for children 3 and up.

Still, the journey to get her two small children vaccinated this year “took many months,” she says.

Another factor contributing to the low uptake is simply a lack of enthusiasm for the shot.

“Many people across the country have decided that Covid-19 is no longer a problem,” Hackell says. “They’re just not going to get it for their kids.”

This accumulation of setbacks comes as early indicators show Covid-19 increasing. For the week ending November 25, the number of positive Covid tests is up 1.2% from the week prior. Emergency department visits and hospitalizations are up 10%.

Hospitalizations in children between 6 months and 4 years are low. About 2 out of every 100,000 children younger than 5 were admitted to the hospital with Covid-19 during the week ending November 11, compared with 5 out of every 100,000 adults. Rates for children 5 to 17 years were even lower, with 0.3 Covid-19 admissions per 100,000 people.

Even with those low figures, Labarre, who works for a grass-roots organization focused on child welfare and health equity, says the campaign to vaccinate as many people as possible should not be abandoned, especially during the holiday season.

“There’s so much effort that went into the communications campaigns about the importance of the vaccines, the safety of the vaccine,” Labarre said. “I feel like the limited access there is now has sort of made that huge investment all for naught.”

Both Labarre and Lanphier say they are lucky they have the time and flexibility to search for the vaccine.

“For people who don’t have the privilege of something like a flexible work environment like I do, I can’t even imagine,” Labarre said. “You have to be very dedicated.”

CNN’s Brenda Goodman and Deidre McPhillips contributed to this report.

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